CLAIM FOR LIFE INSURANCE PROCEEDS (NSLI & USGLI), INVITATION AND CLAIM FOR ONE SUM PAYMENT (NSLI & USGLI), CLAIM FOR MONTHLY INSTALLMENTS (NSLI), AND CLAIM FOR MONTHLY INSTALLMENTS (USGLI)

ICR 199503-2900-012

OMB: 2900-0060

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
2900-0060 199503-2900-012
Historical Active 199107-2900-014
VA
CLAIM FOR LIFE INSURANCE PROCEEDS (NSLI & USGLI), INVITATION AND CLAIM FOR ONE SUM PAYMENT (NSLI & USGLI), CLAIM FOR MONTHLY INSTALLMENTS (NSLI), AND CLAIM FOR MONTHLY INSTALLMENTS (USGLI)
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 06/05/1995
Retrieve Notice of Action (NOA) 03/29/1995
  Inventory as of this Action Requested Previously Approved
06/30/1998 06/30/1998
104,000 0 0
13,867 0 0
0 0 0

THESE FORMS ARE USED BY BENEFICIARIES FOR THE PROCEEDS OF GOVERNMENT INSURANCE POLICIES. THE INFORMATION REQUESTED ON THE FORMS ARE REQUIRED BY LAW, 38 U.S.C. 1917 AND 1952.

None
None


No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 104,000 0 0 104,000 0 0
Annual Time Burden (Hours) 13,867 0 0 13,867 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/29/1995


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